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INFORMATION FOR CANDIDATES
POST OF: Specialist Orthodontic/Maxillofacial Technologist
BASE: University Hospital, Crosshouse
REF NO: T/769/13
Thank you for applying for the above post with NHS Ayrshire & Arran. This information
sheet summarises the terms and conditions related to the post.
Please note if you provide us with an email address on your application form any future
correspondence regarding this post will be emailed to you. If you do not wish to receive
this correspondence by email then please contact us as soon as possible.
A job description and person specification for the post are attached.
This post is Permanent.
The salary for the post is based on the Band 7 salary scale which is currently £30,764 to
£40,558 per annum (pro rata for part time posts).
The hours for the post are 37.5 hours per week.
DISCLOSURE SCOTLAND
PROTECTION OF VULNERABLE GROUPS (PVG) SCHEME
The following provides information relevant to the post you have applied for and requires
your attention and completion.
PVG MEMBERSHIP
The post you have applied for is considered to be in the category of “Regulated Work” as
defined by the above scheme and successful candidate(s) will be required to be a
member of the scheme prior to commencing employment.
Membership currently costs £59.00. The cost of membership, if you are successful in
your application, will be paid by NHS Ayrshire and Arran.
EXISTING PVG MEMBER
Applicants who are already a PVG member will require to confirm their membership and
the regulated workforce this covers, eg, Adults, Children or both. Prior to employment,
NHS Ayrshire and Arran will determine whether the current level of membership is
appropriate for the post offered.
If further membership to cover another regulated
workforce is required, the conditions of membership as stated above will be applied. If
however the level of current membership is appropriate, NHS Ayrshire and Arran will seek
a Scheme Record Update (SRU) and will both pay and incur the costs associated with
obtaining the update.
Further information on the scheme can be found on the Disclosure Scotland website at
www.disclosurescotland.co.uk
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PVG SCHEME MEMBERSHIP MANDATE
(Please complete Sections 1+2 and return with your application)
Section 1. Personal details (* circle as applicable)
Name ____________________________
Post Reference Number:
Post Applied for: ___________________
___________
Are you currently a member of the PVG Scheme
*YES/NO
If YES, please provide
Membership Number _________________
Date of Membership _______________
Date of last Scheme Record Update (if applicable)
Member of which Regulated Workforce:
*Adult
__________________________
*Children
*Both
Section 2. Declaration
I understand if my application for this position is successful, I will require to become a
member of the scheme covering the appropriate regulated workforce.
Signed:
Name:
______________________________
______________________________
Section 3 - For office use only
Full membership required Yes/No
Update only:
Yes/No
SPN:
Date: _______________________
Post Ref no: _________________
Regulated workforce:
Adult / Children / Both
_____________________________
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GENERAL CONDITIONS:
Conditions of Service - The conditions of service are those laid down and amended from
time to time by the appropriate negotiating bodies e.g. NHS Staff Council/NHS Pay
Negotiating Council.
Annual Leave – The leave year runs from 1 April to 31 March. Annual leave entitlement
for full time staff on appointment is 202.5 hours (27 days), with 217.5 hours (29 days)
upon completion of 5 years NHS service and 247.50 hours (33 days) after 10 years NHS
service. Entitlements for part time will be pro rata.
Public Holidays – Public holiday entitlement for full time staff is 60 hours based on the 8
designated Public Holidays per annum, and on a 5 day week working 7.5 hours per day.
The 60 hours entitlement is due to all whole time staff irrespective of work pattern. For
part time staff, this will be applied on a pro rata basis and also allocated in hours.
KSF - The NHS Knowledge and Skills Framework is essentially a development tool but
will also contribute to decisions about pay progression. It will promote equality for and
diversity of all staff, having the same opportunities for learning, development and review.
It will promote effectiveness at work – with managers and staff being clear about what is
required within a post. It will support effective learning and development of individuals –
with all members of staff being supported to learn throughout their careers.
Pensions - Employees are automatically opted into the NHS (Scotland) Superannuation
Scheme. Contributions are at the rate of 9%.
Employees may opt out by obtaining and completing the relevant Opt Out form from the
Scottish Public Pensions Agency website.
Disabled Applicants - A disability or health problem does not preclude full consideration
for the job and applications from people with disabilities are welcome. All information will
be treated as confidential. NHS Ayrshire & Arran has been approved, by the Employment
Services Department, as an Equal Opportunities employer with a positive policy towards
employment of disabled people. NHS Ayrshire & Arran guarantees to interview all
applicants with disabilities who meet the minimum criteria for the post.
You will note on our application form we ask for relevant information with regards to your
disability. This is simply to ensure that we can assist you, if you are called for interview, to
have every opportunity to present your application in full. We may call you to discuss your
needs in more detail if you are selected for interview.
Asylum and Immigration Act 1996 and 2004 (Section 8) - The Asylum and Immigration
Act 1996 and 2004 requires employment checks to ensure that all employees are legally
employed in the United Kingdom. Candidates will be asked to provide relevant original
documents prior to an offer of employment being made. Any offer of employment will only
be made when the organisation is satisfied that the candidate is the rightful holder of the
documents and is legally eligible for employment within the United Kingdom.
Medical Examination - Any offer of employment is conditional upon a satisfactory
medical report from our Occupational Health Services. You may be offered employment
conditional on confirmation that you are medically fit for employment. A commencement
date for employment will only be agreed following this confirmation.
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Policy Relating to Staff with Bloodborne Virus Infection - Candidates for posts which
involve exposure prone procedures will not be allowed to commence employment until
they have been assessed as fit to perform EPPs by Occupational Health. The preemployment screening must be completed prior to any job offer being made. Where a
candidate is not able to perform EPPs, Occupational Health will notify the appropriate
manager that the candidate is ‘fit with restrictions’ and is unable to perform EPPs. The
health status of the individual will not normally be notified to management. Where the
restrictions recommended by Occupational Health are unable to be accommodated due
to the clinical duties of any of the posts within the staff groups specified in the policy, an
offer of employment to the post will not be made.
Candidates who are not offered employment due to being deemed unfit to undertake
EPPs as an essential requirement for a post, may be offered the opportunity to apply for
another advertised vacant post and be considered with other applicants. The preemployment screening for EPP posts above do not apply to staff undertaking non-EPP
posts who could have direct contact with blood, bloodstained body fluids or patients’
tissue in the course of their work activities. These staff will be offered and strongly
advised to be immunised against Hepatitis B in line with the Immunisation Policy including
recall for boosters and further antibody checks.
References - Two satisfactory written references must be obtained prior to any offer of
employment being made. These should include current and previous employers as
requested in the job application form. This is in line with the Recruitment and Selection
Policy.
YOUR APPLICATION:
Informal Enquiries - Informal enquiries are welcomed by Mr Iain Mathieson, Senior Chief
Maxillofacial Prosthetist & Technologist, Oral Facial Laboratory, University Hospital,
Crosshouse,
who
can
be
contacted
on
01563
827320
or
e-mail
[email protected]
Closing Date - Your completed application form should be submitted by Friday 6th
December via the online application form on the SHOW website. Alternatively your
completed application form can be returned to the address below or can be e-mailed to
[email protected]
Department of O&HR Development
63A Lister Street
University Hospital Crosshouse
KILMARNOCK
Ayrshire
KA2 0BE
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1. JOB IDENTIFICATION
Job Title:
Technologist
Highly Specialist Orthodontic Technician/Maxillofacial Prosthetist and
Responsible to (insert job title):
Senior Chief Maxillofacial Prosthetist and Technologist
Department(s):
Oral Facial Laboratory
Directorate:
Planned Care (Head and Neck)
Operating Division:
Patient Services
Job Reference:
No of Job Holders:
1
Last Update (insert date):
09/10/2013
2. JOB PURPOSE
Provide scientific and advisory services to patients for their rehabilitation by restoration utilising
implants, splints, active/passive appliances and prostheses.
3. DIMENSIONS
The Oral Facial Laboratory is the sole unit of its kind serving the patient population of Ayrshire
and Arran and beyond by providing clinical, technical and advisory services to the Maxillofacial,
Ophthalmology, Advanced Restorative Dentistry, E.N.T. and Orthodontic services.
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Specialist in the provision of the orthognathic model planning service
This post is responsible for supervising and training junior members of staff and
students so that timely and high quality technical support is provided for all service
users
Designated signatory for i.e. non- stock and stock requisitions, purchase orders and
invoice certification
Providing through design and fabrication, complex and highly complex range of
appliances for the Maxillofacial, Orthodontic, Restorative, Ophthalmology, Ear Nose
and Throat Specialised Services.
Providing clinical and technical service to ophthalmology patients when requested by
the Senior Chief Maxillofacial Prosthetist and Technologist
Providing clinical and technical service to E.N.T./Maxillofacial patients in the provision
of facial prostheses when requested by the Senior Chief Maxillofacial Prosthetist and
Technologist.
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4. ORGANISATIONAL POSITION
Senior Chief Maxillofacial Prosthetist and Technologist
Secretary
Highly Specialist Orthodontic Technician
Post holder
Specialist Orthodontic Technician
Specialist Orthodontic Technician
Students
5. ROLE OF DEPARTMENT
Provide scientific and advisory services to the patient population of Ayrshire & Arran and
beyond through provision of the following:
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Artificial Eye design, fabrication and fitting service
Facial Prosthesis design, fabrication and fitting service
Orthognathic Surgical Planning service
Orthodontic Appliance design and fabrication service
Maxillofacial Appliance design and fabrication service
Restorative Appliance design and fabrication service
Osseointegration Implantology design, fabrication and fitting service
All of the above specialised services require the necessity to liaise with consultants, junior
medical staff, patients and other relevant parties to ensure up to date information and
episodes relating to patient care and future planning of treatment.
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6. KEY RESULT AREAS
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Provision of a broad and extensive range of restorative appliances incorporating
innovative design and fabrication techniques for the restoration of speech, mastication
and facial form
Provision of a broad and extensive range of highly complex orthodontic appliances
incorporating innovative design and fabrication techniques for the correction of patients’
malocclusions and tempromandibular joint dysfunction
Provision of highly specialised intra oral osseointegrated implantology retaining systems
incorporating consultation, design, fabrication, fitting and maintenance for use in
retaining oral prosthetics in situations where normal means of prosthetic retention is
impossible, e.g. patients with atrophic mandibular/maxillary edentulous ridges, oncology
patients having undergone radical ablative surgery for tumour removal etc
Provision of a broad and extensive range of highly complex maxillofacial appliances
incorporating innovative design and fabrication techniques in the treatment of
craniofacial injuries.
Ability to deputise on a rotational basis for the Senior Chief Maxillofacial Prosthetist and
Technologist by being responsible for the departments capital and revenue budgets to
ensure the operational efficiency, quality of work, purchasing of equipment/supplies and
contracting out of work to external laboratories provides value for money.
Provide risk assessments for designated laboratory areas.
Supervise and training of junior staff or students and fellow professionals and to prepare
material for post graduate courses as required
Practitioner in the delivery of clinical, technical and advisory expertise in the provision of
the orthognathic surgical planning service for the correction of mandibular/maxillary
skeletal jaw discrepancies requiring osteotomy surgical intervention.
Involvement in the care of facial/ocular patients who require regular maintenance of their
prosthesis
Identify action research and development as required for own mandatory Continuous
Personal Development. Required to support and be involved in clinical trials and
equipment testing
Participate in Continuous and Personal Development Plans through regular appraisals
with Senior Chief Maxillofacial Prosthetist and Technologist
Participate with clinicians as appropriate and advise other health care professionals
relevant to scope of own knowledge and practice on matters specific to the Oral Facial
Laboratory specialised services
Provide clinical and technical information regarding the long term management of a
medical device
Use and programme computerised systems in the production of medical devices
Observe and comply with current Health and Safety and COSHH legislation to safely
handle and use laboratory equipment
Comply with Medical Devices Directive 93/42/EEC ensuring all materials, component
parts and processes for appliance patient provision meet national guidelines
Adhere to departmental policy/guidelines regarding cross infection
Monitoring the administration of laboratory work as necessary
Maintain the strictest confidences in relation to personal related information of patients
Set up, use and maintain computer controlled equipment in the production of medical
devices
IT communication skills required, e.g. email, word processing to produce written reports,
internet for research purposes and compiling presentation materials.
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7a. EQUIPMENT AND MACHINERY
Socket Extractors - for the removal of ocular prosthesis from anophthalmic/eye sockets.
Torque Driver - a specialised instrument incorporating a torque limiter to ensure that
when screwing Branemark Osseointegrated Implant components into the connecting
abutments or implant fixtures which are embedded in facial/mandible maxillary cortical
bone, that the correct amount of torque required to connect the components together is
supplied (very important as over tightening can result in implant failure).
Branemark Magnetic Screwdrivers - utilised for the connection/removal of magna
caps/magna abutments to osseointegrated Branemark/Bonefit implant systems,
abutments and fixtures which are imbedded in cortical bone.
Branemark Implant Screwdriver – a specialised instrument required for torquing gold
screws into Branemark osseointegrated implant components for retention purposes.
Hanau Face bow - used to record and transfer patients facial/skeletal information, e.g.
face bow recording is taken by attaching bow to condyler heads of patient's mandible, bite
fork to maxilla and orbital pointer is placed on lower border of orbital bone. This records 3
points of reference for data transfer on to a specialised recording instrument called an
articulator prior to orthognathic model surgery planning taking place.
Centrifugal Casting Machine - used in the casting of metals for the provision of silver
cast cap splints required in the treatment of facial, mandibular, maxillary bone fractures
by relocating and stabilising the fractured fragments in place to permit bone healing to
take place. Also used in the casting of metals for the provision of silver cast cap
orthodontic expansion appliances required in the treatment of patient malocclusions.
Furnace - required for heating and burning out of wax from splint investment models prior
to casting of silver cast cap splints and rapid expansion orthodontic appliances.
Computer Controlled Dry Heat Electric Oven - required for the processing of various
types of materials by changing the materials from, e.g. acrylics from dough stage to hard
acrylic stage, silicones from a runny/stringy stage to a soft solid stage in the manufacture
of prosthesis, in the treatment of hemi/partial maxillectomy patients, restorative,
maxillofacial and orthodontic appliances.
Computer Controlled Soldering Unit - required for the soldering of gold, stainless steel
appliance and system components, e.g. gold bars onto gold abutments as a process in
the forming of implant retention systems. Stainless steel wires and tubes in the
fabrication of orthodontic appliances, etc.
Gas-Air Blow Torch - required for soldering of nickel silver wire in the fabrication of
mandibular/maxillary arch bars for the stabilisation of fractured bone fragments in the
treatment of patients’ trauma injuries; heating of investment moulds and subsequent
soldering of gold bar/implantology components in fabrication of intra-oral retention
systems.
Polishing/Abrading Units Incorporating Internal Extraction Systems - utilised in the
abrading/polishing processes of appliance fabrication.
External Fume Extraction Systems – utilised for the safe removal of harmful fumes
created in the fabrication of medical devices, e.g. soldering, metal casting, heating of
investment moulds, etc.
Sandblaster - required for removal of contaminants from the surfaces of metal splints
(cast cap) and appliances.
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Computer Controlled Electrically Heated Pressure Vessel - utilised in the manufacture
of auto polymerising acrylic resin materials, e.g. changing the state of acrylic resin from a
fluid material into a hard surface material in the forming of orthodontic, maxillofacial
appliances and devices, etc.
Light Cure Processing Unit - utilised for fabrication of patients’ impression trays,
additions of occlusal cover to restorative orthodontic appliance, appliance fabrication
where patients have sensitivity to acrylic resins.
Microwave - required for quick method heating of reversible hydrocolloid material for
model duplication purposes.
Dry Heat Oven - utilised for heating and drying of working and study models and
preparation of models prior to orthognathic surgery planning.
Fridge - utilised for the storage of materials to extend shelf life.
Computer Controlled Hydromat Boiling Out/Processing Unit - required for
automatically flushing wax from plaster moulds and then processing acrylic resin material
under pressure for a pre-programmed period of time changing material state from dough
to solid.
Computer Controlled Safety Cell Trimming Units Incorporating Integral Dust
Extraction Systems and Micro Motor Hand Pieces - for the trimming, shaping of
appliances utilising computerised electrical micromotors with constant adjustable dust
extraction employed.
High Speed Grinder - required for the trimming to shape of extremely hard metals such
as cobalt chromium.
Computer Controlled Downflow Fume Extraction Systems - employed to remove
harmful methyl-methacrylate fumes in the mixing and spraying techniques involved in
acrylic resin appliance /prosthesis fabrication.
Steam Cleaner – required for removing residue from appliance surfaces following deflasking process.
Magnifiers – for enlargement of intricate and extremely fine items of work.
Computer Controlled Duplicating Machine – utilised for the duplication of large
numbers of plaster models.
Computer Controlled Vacuum Mixer - required for the mixing of plaster of paris/stone
model materials producing a vacuum to ensure that all air is removed from the material
prior to use in model casting.
Electrical Orthodontic Plaster Trimmer - required for trimming of plaster/stone models
essential for the production of orthodontic study/working models and orthognathic surgical
planning models.
Disinfection Baths – utilised for disinfection of body and oral impressions.
Workstation Dust Extraction Systems - required for removal of harmful acrylic/metal
dusts created through shaping and trimming process.
Natural Daylight Lighting - required for tissue matching patient’s skin tones with suitable
shaded silicones so that body prosthesis mimics natural tissue tones of individual
patients.
Workstation Natural Daylight Lighting – essential for fabrication of extremely fine
appliance wires, components in the provision of patient prosthetics and the modelling of
dental waxes.
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Laptop Computer - for viewing records of patient’s body appearance and providing
presentations to members of staff and visitors - providing presentations.
Electric Carving Knife - required for trimming excess vacuum forming material from soft
and hard laminated mouthguards, anti-snoring appliances, essix retainers, etc.
Vacuum Forming Machine -utilised for adapting various types of plastic material closely
to working models in the fabrication process of mouthguards, anti-snoring devices, essix
orthodontic retainers, vacuum trauma splints, etc.
Glue Gun - utilised for dispensing specialised adhesive glues onto soft laminate materials
for bonding of maxillary/mandibular components when fabricating anti-snoring devices.
Dental Surveyor Parallelometer - utilised for analysing the path of insertion and
planning and tracing of plates and clasps by locating and recording undercut depths
present in patients’ maxillary/mandibular arches, prior to appliance fabrication.
Various Types of Anatomical Articulators - utilised for orthognathic model planning
following transfer of patients data by face bow and appropriate model surgery employed
establishing the required movements of the maxillary/mandible through splitting or resetting of jaw in theatre to establish normalised jaw relationship ensuring balanced
occlusion of prosthodontic/maxillofacial appliances.
Full Sets of Orthodontic Pliers and Cutters - required for the forming of extremely
intricate, fine wire components in the fabrication of all types of orthodontic and certain
maxillofacial appliances.
Full Sets of Carving and Modelling Instruments - required for the sculpting and
modelling of various consistencies of wax to form nipple areola prosthesis/oral
prosthetics/certain types of orthodontic appliances, etc.
Sterile Instrument Kits for Orthognathic Appliance- required for the recording of facial
data in the treatment of orthognathic appliance fabrication.
Bunsen Burners – required for heating of various types of waxes for sculpting, modelling
purposes in the prosthesis/appliance fabrication.
Micro-torches - required for flaming and smoothing of modelling/carving/casting waxes
during sculpting and modelling procedures.
X-Ray Viewer - utilised when viewing patients’ radiographs prior to orthognathic model
planning surgery/immobilisation of jaw/facial fractures, etc. Positioning of implantology
fixtures in cortical bone (determining ideal position).
Clinic Patient Chair - required for treatment of patients.
Electronic Weighing Scales - required for calculating ratio of silicone body elastomer to
be mixed with silicone catalyst to provide a patient prosthesis of the desired specifics, e.g.
degree of softness required in relation to shore hardness, etc.
Computerised Vernier Gauge - required for measurement of appliance components,
base plate, occlusal, anterior bite platforms, etc.
Calipers – for recording material thickness of appliances to microns of accuracy
Plaster Oscillator - utilised for the removal of occluded air from plaster/investment
material during casting/investing procedures.
Ultrasonic Bath - utilised for the removal of ingrained materials from appliances following
de-flasking of appliance from plaster or investment moulds. Also used in conjunction with
ammoniated cleaning fluid for the removal of tarnish from metals.
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Computer - for producing typewritten documents, maintenance of databases, retrieval of
information, accessing email, internet for research and development purposes, etc.
Printer/Scanner/Copier - producing hard copies of work stored on computer.
Fax Machine - sending and receiving facsimile documents.
7b. SYSTEMS
Manual Records – appliance prescription cards stored chronologically for retrieval by
technical/admin staff; diaries of appliance/work requests updated daily; files holding
information on Laboratory staff for leave, training, etc; paper diaries of staff; resource files
for reference purposes, e.g. Safety Health and Environmental Manual, Child Protection
Protocol Manual, requisitions placed retained for reference/invoice processing purposes,
brochures of supply companies, etc
Patients’ medical photography - filing systems on J-peg, slide and photographic prints
which can be accessed at future dates for patients review purposes. Also for teaching
and training purposes for Junior Members of staff/students, e.g. presentations, etc where
permission has been explicitly given by patients.
Medical Devices Directive Recording and Tracking System - This system is utilised
for the documenting of C marked materials and components which are provided to
patients through the provision of prosthesis and appliances on completion of their
treatment plans. This also permits the tracking of components and materials to their
supplying company where LOT numbers can be checked for conformity where failure of
material component has occurred. These forms are filed in chronological order and
retained for 5 years.
Safe Systems of Work - Located through resource file and computerised information
system. carrying out the work to ensure adherence to the approved systems. A reference
system requiring to be complied with to ensure that approved and documented safe
systems of work are followed in the day to day fabrication and provision of appliances.
Risk Management - Located through resource file and computerised information
systems. A system requiring to be accessed and complied with to determine the risks
arising from identified hazards and the appropriate precautions to be taken within the
workplace.
Osseointegrated Implantology Systems - Employed in the production of patients
restorative appliances. Customised components
required for patients are ordered in advance from
supplier, with patients’ details provided for medical
device certification to be issued with components
specific to the individual patients. Components are then
fitted to patients at various stages of treatment gradually
building up the retaining systems of choice and
fabricating the individual system components together to
permit engagement and retention of the restorative
device to the osseointegrated implantology fixtures
previously embedded in the maxillary/mandibular
cortical bone.
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8. ASSIGNMENT AND REVIEW OF WORK
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Work which is referred to the laboratory from the specialist orthodontic,
maxillofacial and restorative clinics has the appliance type, time and date
information transferred from supplied work cards into laboratory work book.
Appliances which are referred for fabrication from external clinicians for
income generation purposes would be assigned to postholder by the Senior
Chief Maxillofacial Prosthetist.
Complex/highly complex work which is appropriate for the post is allocated
daily by self and undertaken under own initiative.
Work which is of a non familiar/highly complex nature would be issued by the
Senior Chief Maxillofacial Prosthetist.
Work is reviewed by Senior Chief Maxillofacial Prosthetist and
Technologist/Head of Department through regular personal contact and formal
meetings, written reports, e.g. Personal Development Planning.
Quality assurance of work is achieved and maintained through conformity on a
daily basis with Medical Devices Directive 93/42/EEC.
This is an appliance/prosthesis recording system for
material/component conformity and quality control
checking system for adherence to prescription plans
which is countersigned by senior members of staff.
9. DECISIONS & JUDGMENT
Postholder is required to supervise the junior members of staff/students, on occasions
when the Senior Chief Maxillofacial Prosthetist is unavailable. These situations,
although rare, do require utilisation of supervisory skills to ensure that service delivery is
unaffected .
Typical judgements required of the post may involve:
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In the provision of restorative prosthesis for the re-establishment of
mastication, speech and facial aesthetics for patients who have undergone
major oral surgery, e.g. partial removal of mandible/maxilla, etc. and where
prosthetics retention is unachievable through conventional methods, innovative
highly specialised advanced retaining systems are often required to be
employed, such a system would require thorough analysis of radiographs, 3D
models and case conferencing with restorative, Maxillofacial consultants
involved to determine the position and number of implant fixtures to be placed
in the patients central mandibular/maxillary bone. Further judgements are
made as to the type/design of highly complex osseointegrated intra oral
implant retention system which would best aid patients denture stability by
analysing the amount of space available between abutments, vertical height,
available space between abutments and fitting surface of denture, assessment
of patients masticatory force and jaw relationship etc before deciding on the
definitive system to be utilised, e.g. gold bar and clip, closed field magnetic,
ball attachment, combination of magnet and bar, etc.
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Assessment of occlusal bite registration supplied by clinician prior to
fabrication of highly complex functional orthodontic appliance, e.g. clark twin
block, andresen etc to ensure that the mandible has been advanced in
association with increased vertical dimension within set parameters required
for successful muscular action to be channelled into active skeletal base and
tooth movement. When occlusal bite registrations do not adhere to the above
parameters, a discussion would take place with clinician involved and a new
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occlusal registration requested. Typical decisions and judgements would
include requirement to design appliance (when clinicians do not complete
appliance cards and rely on the knowledge of the technician) and construct
highly complex functional appliances which are invariably used in the
treatment of the most severe malocclusions; functional component analysis,
i.e. patient requirement and appliance capability, is essential preliminary to the
design of the functional appliance; be able to assess the accuracy of the
clinical records; position and type of retentive and active components;
assessment of the retentive and active components for an adequate
anchorage; depth of buccal shields when constructing Frankel appliance;
position and angulation of the occlusal planes is crucial to efficiency in
correcting arch relationships when constructing Twin Block appliances.
Required to design and construct highly complex intra oral obturation devices for
patients who have undergone ablative surgery, e.g. hemi-maxillectomy, where a
large proportion of the maxilla has been surgically removed. Analysis of the
tissue morphology of the defect area is essential to determine the type of
obturation system best suited depending on analysis of undercut areas present
in defect site and patient’s tissue condition. After close examination, a decision
would be made as to the type of material to be used, e.g. heat cure/self cure/light
cure acrylics, soft silicone, expanding foam, etc. Additional means of support
required for retention of the prosthesis, e.g. lever system, buccal springs,
implantology system incorporating retentive framework within prosthesis with full
analysis and consideration given to the prosthetic ramifications involved.
Orthognathic Model Surgery
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When treating patients requiring orthognathic surgical model planning prior to
theatre admission for the correction of mandibular/maxillary skeletal jaw
discrepancies requiring osteotomy/ostectomy surgical intervention.
As
practitioner in the technical aspects of this field of work, all problems
encountered in relation to the surgical model planning would be resolved by
self following on from establishing patient information across multi-disciplines
case-conferencing with specialist maxillofacial consultant surgeons,
orthodontic consultants and junior medical staff.
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For example, determining timescale for various stages of surgical planning to
be completed to ensure that the final surgical plan is achieved prior to patients
scheduled theatre date. The completed surgical plan will have incorporated
analysis, calculations and orientation of segmented model sections simulating
the corrective mandibular/maxillary bone fractures and movements to be
achieved in theatre.
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Recording of patient data pertaining to initial jaw positions prior to planning
and final position of jaws following corrective post surgical position of
mandible and maxilla, e.g. level of advance, impaction, occlusal cant, rotation
centre, line movement, etc.
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Analysis, calculations and recording of data would be involved in the design
and fabrication stages of fixation devices required for the holding and
positioning of the fractured jaw segments in theatre, e.g. splints, arch bars,
intermediate and final wafers, anterior projection bars locking plates, etc

Further analysis, calculations and recording of data pertaining to model
accuracy would be undertaken by self, e.g. orthodontic adjustment, cuspal
modifications, occlusal relationship positioning, etc.

Following on from taking face bow recording of patient in clinic and final
adjustment of intermediate and final wafers when fitting over patient’s teeth to
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ensure that no premature contacts exist. The treatment details would be
recorded in patient’s casenotes.
10. MOST CHALLENGING PARTS OF THE JOB
The number of specialties that the post requires to provide direct services to, and the
diversity of knowledge and skills required for the provision and implementation of each
individual service, inevitably can result in difficulties being experienced through the
frequency of unavoidable interruptions. Due to the nature of the post, keeping up to date
with the latest innovative techniques for each specialised service becomes very
challenging as many units in the country have departments specialising in a single
individual specialty only. This post has to achieve and maintain similar high levels of
knowledge and skills in not one but three separate specialties in the provision of high
quality services to patients.
When treating oncology patients who have undergone radical ablative surgery for the
removal of malignant oral tumours resulting in a large area of palate removal (hemimaxillectomy) – these patients require provision of dental obturators to fill the defect site
to 1. prevent food particles and fluid entering the nasal cavity; 2. restore mastication and
speech; 3. restore facial contour. Additional retention may be required through the
utilisation of implantology systems. Jaw movement may be inhibited through damage to
tempromandibular joint as a result of radiotherapy treatment.
Rehabilitation of the joint movement may be required through the fabrication of a trismus
screw in an attempt to re-establish jaw opening to facilitate impression taking and
prosthetic appliance provision. Due to the high complexity of the patient treatment plan,
difficulty is often experienced with providing this type of patient with a successful
functional, stable and aesthetically pleasing device. Non-conventional approaches have
often to be employed requiring lateral thinking to surmount the many technical problems
encountered.
During the numerous treatment appointments that these patients have to endure,
distressing situations can be experienced due to the patient’s prognosis which can be of a
terminal nature.
11. COMMUNICATIONS AND RELATIONSHIPS




Orthodontic, Maxillofacial, Restorative Consultants and Junior Medical Staff
– require frequent communication face to face and by telephone for information
sharing on appliance design
Theatre Staff – face to face when requested to attend theatre for advisory
purposes regarding obturation intra oral implant patients, etc.
Nurses – frequent communication face to face and by telephone for training of
nurses and information sharing regarding timescale for appliance
construction/disinfection of impressions, etc to ensure appliances are delivered to
external hospitals on due date/time and to ensure collection and distribution of work
takes place
Laboratory Secretary – frequent communication face to face/written information
regarding used material items for stock control purposes. Information regarding
equipment repair and liaising with Secretary regarding admin aspects of training,
patient prescriptions, updating personnel records.
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
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
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
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


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Patients –frequent communication face to face, e.g. constructing.
relieving/adjusting patients’ prosthesis/ appliances at chairside witnessing consent
forms for medical photography; giving opinion/reassurance regarding cosmetic
result of facial/ocular prosthesis; Clinical appointments for fitting orthognathic
facebow recording device to patients for establishing points of reference data and
subsequently transferring information into the model plan prior to surgery, these
patients often require persuasion/reassurance due to the complexity of the
apparatus involved which can be very off-putting for the patient. Many patients
require to be shown empathy in regard to recent ablative surgery due to trauma,
disease or congenital defects.
College/University Lecturers – Face to face, email, telephone communication
required when attending post graduate courses.
Sales Representatives – Telephone, face to face communication when receiving
information regarding laboratory materials, equipment and products. Involvement in
specialised prototype component testing, attending company demonstrations.
Education Department– Face to face/email/telephone/written communication
when providing table top demonstrations/presentations to public, e.g. to large
groups of school leavers who have an interest in medicine as a career and Open
Days. Also in relation to distance learning when taking part
Various internal departments - e.g. human resources, IT and Communication
and Works Departments – face to face, telephone, written and email regarding
information sharing and reporting.
External Laboratory Contractors – telephone, written communication for
relaying appointments/invoices/technical information and involvement in
provision of specialised training courses.
Medical Photography – face to face/telephone contact requesting picture
format, quantity and viewing angle to be taken of patient/prosthesis for reference
purposes
Other Laboratory Staff – daily face to face/telephone/written/email contact
regarding, e.g. information sharing, workload issues, advice and guidance
training, laboratory staff meetings including requirement to participate in delivery
of technical presentations.
Technicians From Other Health Board and External Laboratories – face to
face, telephone, written and email communication regarding information sharing,
design of appliances requested, quality of work issues, etc.
Medical Records- Requesting and returning patient case records.
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
PHYSICAL EFFORT/SKILLS:
Highly developed manual dexterity skills required when constructing precision appliances
by the use of specialised instruments and equipment for the manipulation of extremely
fine and intricate components such as micro screw systems, osseointegrated implantology
components and associated materials. Highly developed artistic skills are a pre requisite
for sculpting and shaping synthetic materials to imitate and recreate the form of lost
human tissue. Excellent colour differentiation is a requirement for colour matching the
synthetic prosthesis to the natural human tissue shades around the defect site.
Keyboard skills required for communication purposes.
Physical effort needed for the job - frequent standing or sitting for long periods, sudden
lifting effort for short periods.
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Standing for protracted periods of time attending theatre, various stages of
prosthesis\appliance fabrication e.g. flasking\packing\polishing. Clinic sessions e.g. tissue
matching, etc.
Sitting for protracted periods of time fabricating orthodontic\maxillofacial\prosthodontic
appliances\ prosthesis etc.
Lifting requiring sudden short bursts of effort e.g. lifting heavy 25kg bags of plaster,
manoeuvring patients into chair, carrying\lifting material\equipment deliveries into stock
cupboard etc.
Sitting for periods of time at computer using keyboard skills for word processing and using
internet for research and development purposes
MENTAL EFFORT/SKILLS:
Requirement for frequent intense prolonged concentration when dealing with orthognathic
surgery planning. Intense concentration required when colour matching patients’ tissue
tones with appropriate pigments to produce a colour matched prosthesis. Daily
concentration required when intra oral implants are involved, complex and highly complex
orthodontic\maxillofacial and prosthodontic appliances, obturation cases etc.
Due to the extremely broad spectrum of specialised work undertaken and the nature of
that work being
of a non routine nature it is inevitable that perpetual interruptions complicate the working
day.
ENVIRONMENTAL AND WORKING CONDITIONS OF THE JOB:
Regular contact with body fluids when treating patients e.g. as part of patient hygiene
control cleansing mucopurulent matter from ocular patients anophthalmic sockets,
cleansing blood and debris from around osseointegrated implant abutment sites, dealing
with patient sickness, registering face bow recording in patients mouth, and fitting
orthognathic wafers onto patient’s teeth, handling appliances removed from oral cavity.
Monomeric fumes from acrylic resins used in prosthesis\appliance fabrication, fine pumice
dusts created during abrading of appliances, fine dusts\fumes when heating and abrading
nickel\silver during the fabrication of arch bars for the stabilisation of fractured bone
segments in trauma treatment, risk of inhalation of fine silica dust particles during the
investment stage of metal cast cap splint construction used for the stabilisation of
fractured bone segments, inhalation of fine plaster dusts when model casting etc.
Working alone with patients, where the potential for exposure to verbal\physical
aggression inevitably exists.
Noise pollution during operation of laboratory machinery and equipment.
EMOTIONAL DEMANDS OF THE JOB:
Due to the nature of the post which involves the rehabilitation through the prosthetic
restoration of patients who have undergone radical ablative surgery, distressing
circumstances are routinely encountered when treating this patient group. Examples of
such circumstances are as follows.
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Treatment of patients who have recently been diagnosed as terminally ill.
Empathising with terminally ill patients’ family.
Treatment of malignancy patients who have undergone extensive radical ablative surgery.
These types of patients are often mentally traumatised due to the extent of their
disfigurement and require to be shown considerable empathy and given continuous
reassurance and motivation.
WORKING CONDITIONS:
Frequent exposure to controlled harmful substances, e.g. monomeric fumes from acrylic
resins involved in appliance construction.
Inhalation of fine dusts during abrading/polishing/casting/ procedures.
Vibration of hand when using micromotors. Inhalation of fumes during soldering process.
Contact with body fluids during various patient procedures. Potential for exposure to
verbal/physical aggression by patients during clinic appointments.
13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
BSc (Hons) Degree in Dental Sciences or equivalent.
+
MSc in Maxillofacial & Craniofacial Technology (3 years) or equivalent to gain membership
of the Institute of Maxillofacial Prosthetists and Technologists.
+
Postgraduate Diploma in Orthodontic Technology (2 years)
plus further experience and training in a range of advanced orthodontic technical
procedures to
Masters Degree level equivalent.
+
Substantial knowledge and experience of highly complex
Technology (5years)
advanced Prosthodontic
+
Registration with the General Dental Council
+
Registration with the Institute of Maxillofacial Prosthetists and Technologists

Computer proficient requiring a working knowledge of Microsoft Software
Packages.

Experience of teaching students and other fellow professionals in
clinical/technical aspects of undergraduate and postgraduate course content.
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
Experience of invasive intra-oral and extra-oral, clinical procedures and
operating theatre practice.

Knowledge of advanced craniofacial techniques associated with extra-oral
osseointegrated implantology.

In depth knowledge and experience of advanced restorative techniques
associated with intra-oral osseointegrated implantology.

Knowledge and experience of orthognathic surgical planning systems.

In depth highly specialised knowledge and a minimum of 5 years postgraduate
experience of orthodontic functional, fixed and removal appliances.

In depth highly specialised knowledge and experience of restorative obturation
devices.
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Fully conversant with legislation covering data protection and patient
confidentiality.

Knowledge of current COSHH, health and safety legislation to safely handle and
use laboratory equipment and materials.
Knowledge of legislation relating to Medical Devices Directive 93/42/EEC ensuring all
material, component parts and processes for prosthesis and appliance patient provision
meet national guidelines through knowledge of relevant materials science, use of biocompatible materials, chemistry, rheology and toxicology.
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NHS Ayrshire and Arran
Person Specification
Post Title
Highly Specialist Orthodontic Technician/Maxillofacial Prosthetist & Technologist
Post Reference Number
Selection Factors
(Person Specification)
QUALIFICATIONS &
TRAINING
Criteria
Essential
BSc (Hons) Degree in Dental Sciences or equivalent; Postgraduate Diploma in Orthondontic Technology
plus further experience and training in a range of advanced orthodontic technical procedures to masters
degree level equivalent; MSc in Maxillofacial & Craniofacial Technology or equivalent
Desirable
Full Membership of the Institute of Maxillofacial Prosthetists & Technologists (IMPT)
EXPERIENCE
Essential
Desirable
KNOWLEDGE
Essential
Desirable
COMPETENCIES &
SKILLS
Essential
Desirable
PERSONAL
CHARACTERISTICS AND
Essential
Substantial post qualification experience in orthodontic technology
Substantial experience in advanced prosthodontic technology
Relevant post qualification experience in maxillofacial and craniofacial technology
Experience of working in a multi-disciplinary team
Understanding of Windows applications
Understanding of advanced restorative techniques associated with intra-oral osseointegrated implantology
and obturator devices
Understanding of advanced orthodontic design and fabrication techniques
Understanding of the processes involved in Orthognathic surgical planning
Understanding of craniofacial techniques associated with extra-oral osseointegrated implantology
Understanding of ocular prosthetics and patient management
Good written and oral communication skills
Good organisational skills
Maintains responsibility for own Continuous Professional Development (CPD)
High level of manual dexterity skills
Understanding of Clinical Governance
Competent in the role of Risk Assessor
Constructively respond to knowledgeable assessment of own conduct and proactive ability to self-motivate
and work on own initiative
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Ability to work effectively under pressure
OTHER
Desirable
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